Single Dose Del Nido Cardioplegic Solution In Mini-invasive Mitral Valve Surgery.
Radosław Zwoliński, Piotr Janusiewicz, Maciej Zagórski, Michał Krejca.
Medical University of Lodz, Pomorska 251, Lodz, Poland.
Background: To investigate the early and midterm results of using single dose of Del Nido cardioplegic solution (DNS) in mini-invasive mitral valve (MV) surgery. Methods: From 03/2017 to 12/2019 - 90 mini-invasive mitral procedures using single dose (DNS) was performed (MV annuloplasty 73 and 17 MV replacement). The indication for surgery was severe insufficiency ( 77), stenosis (6 ) or complex pathology (7 ). 3 patients had infective endocarditis. Patients refered to reoparation was excluded from the group because were operated on fibrillating heart. All procedures were performed by a single surgeon and it has been beginning of the mini-invasive program in our Department. Mean Euroscore for the group was ( 3,5 +/- 5,95). The investigation was performed to determinate preoperative parameters (age, sex, BMI, EF, FA, SPAP, risk factors) intraoperative (operating time, cross-clamp time, ECC time, drainage, ventilation, pleurocentesis, hospitalization time). All patients received 1000 ml (DNS) and 5/90 patients got additional portion of 500 ml of DNS after 90 minutes of operation. Results: In hospital mortality ( 2,2%) -2 patients. One patient died because of myocardial infarction from LAD developed in 5th postoperative day, another patient died due to pulmonary insufficiency in 33 day. No stroke and renal insufficiency was observed. Chest revision because of bleeding was performed in 4 patients. One patient had reoparation 5 months post first procedure because of infective endocarditis and disconnection of mitral annulus. No death in average 18 months follow up. Conclusion: Use of single dose Del Nido cardioplegic solution is safe with optimal perioperative and midterm results and can be introduced from the beginning of mini-invasive mitral valve program.
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